An oral contraceptive pill is to be taken at the same time every day. It is common to miss a contraceptive pill due to hectic schedules, forgetfulness, or other reasons. Thus, it is important to know the steps needed to minimise the risk of unintended pregnancy.
Contraception
There are many forms of contraception to protect against pregnancy. Some are to be taken as a pill every day, while others are nonhormonal contraception, such as condoms.
What happens if you miss a contraceptive pill?
To begin with, individuals should know which type of pills they are taking. Each oral contraceptive pill varies in its instructions regarding missed doses. The combined pill or the progesterone-only pill has differing active pills and inactive pills schedules, hence differ in the steps in missing a dose.
The packaging of the pill usually has an insert with instructions on what to do. Otherwise, a healthcare provider can be contacted for guidance.
What to do when you missed the progesterone only pill?
Firstly, take the missed pills as soon as you remember. This pill has a 3-hour window, which means if the time to take the pill was 3 or so hours ago, it should be taken asap. However, if you are more than 3 hours late, then you will need to use an additional type of birth control for 2 days or abstain from sex altogether.
If one day is missed, take the tablet right away, even if it means taking two pills in one day. If more than 2 pills have been missed, then 2 need to be taken as soon as you remember and 2 on the following day. The rest are taken as normal.
What to do when you miss the combination pill?
These come in different pill packs. Some of them have 28-day tablets followed by placebo pills or inactive pills for 7 days. Some packs only have 21 active tablets and are designed to be taken for 3 weeks with one week off to allow for a period.
When starting a new pack, and if the colour of pills is different, it’s best to ask the pharmacist or doctor if there are hormone-free pills in the pack. The inactive pill is only designed to help keep you in routine, so if you miss the hormone-free pill, there is no harm and no risk of getting pregnant.
If one pill is forgotten, it should be taken as soon as you can. If it’s been more than one day, another form of birth control needs to be used for the next 7 days if you are sexually active. If you have missed taking 2 or more pills, take the most recent missed pill, but disregard the others that have been missed.
Continue the rest of the pills like normal and use other methods of birth control. If the missed pills are from the week before the period, the active pills should be taken during the period and continued onto a new pack.
When to consider emergency contraception?
If the missed pill has crossed the acceptable window, and unprotected sex has occurred, it is vital to consider emergency contraception if pregnancy is to be avoided. There are two types of EC, one can be used for up to 72 hours, and the other for up to 5 days. However, the effectiveness of the tablet in preventing pregnancy declines as the days go by. The sooner you take EC, the better the chances of it working effectively.
If the Ella emergency contraceptive is used, it is important not to take your usual contraceptive pill for 5 days after it. During this time, another method could be used if sexually active.
Can I use a birth control pill as EC?
It is believed that combined oral pills can be taken as an emergency contraceptive. They need to be taken at higher amounts and 12 hours apart. However, each brand has different strengths of the hormone, and it is best avoided or to ask a doctor how many pills can be taken to use it as emergency contraception.
Side effects of missing birth control pills
The most common side effect of missing a tablet is light bleeding or starting the period with menstrual cramps. It can also cause nausea. The reason the bleeding occurs is that the ovaries may release an egg if you miss a pill, which raises the risk of accidentally getting pregnant if the missed pill protocol is not followed.
On missing a pill, some individuals may get headaches or migraines due to the sudden low of oestrogen in the body. This should not phase women on the progesterone-only pill.
How to avoid the missed tablet problem?
To minimise the risk of missing future doses, or if this begins to become a regular occurrence, it would be good to establish a reminder system. Options could include setting alarms on the phone, using pill reminder apps, or adjusting the time of taking the pill.
Another option could be to consider an alternative contraceptive method. If oral tablets are hard to adhere to, options such as injectable or rod could be considered for long-term protection. Otherwise, non-hormonal methods such as a female diaphragm or male condom may be better suited as they can be used on demand.
Consulting a doctor
It is important to consult your healthcare provider if taking the tablets daily is troubling you or if it’s resulting in missed tablets. They can provide personalised guidance with other alternatives to explore if needed.
